A5074990583- Healthcare Policy and Management
- Global Health Care Issues
- Primary Care and Health Outcomes
- Healthcare Systems and Reforms
- Health Systems, Economic Evaluations, Quality of Life
- Muscle Physiology and Disorders
- Multiple Sclerosis Research Studies
- Muscle activation and electromyography studies
- Patient-Provider Communication in Healthcare
- Neurogenetic and Muscular Disorders Research
- Diagnosis and Treatment of Venous Diseases
- Peripheral Neuropathies and Disorders
- Genomics and Rare Diseases
- Neonatal Respiratory Health Research
- Patient Satisfaction in Healthcare
- Rheumatoid Arthritis Research and Therapies
- Acute Lymphoblastic Leukemia research
- Behavioral Health and Interventions
- Health disparities and outcomes
- Atrial Fibrillation Management and Outcomes
- Children's Physical and Motor Development
- Healthcare cost, quality, practices
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Epilepsy research and treatment
- Interprofessional Education and Collaboration
Analysis Group (United States)
2022-2025
University of Pennsylvania
2017-2022
Philadelphia University
2022
National Bureau of Economic Research
2016-2020
Wilmington University
2020
Harvard University
2016-2017
As the multiple sclerosis (MS) disease-modifying drug (DMD) treatment options have expanded to include oral therapies, it is important understand whether route of administration associated with DMD adherence. The objective this study was compare adherence DMDs in patients MS newly initiating a self-injectable versus an DMD.This retrospective database used IMS Health Real World Data Adjudicated Claims - US data between July 1, 2010 and June 30, 2014. Adherence measured by medication...
The commercial health insurance market is characterized by consistently high enrollee turnover. Turnover can disrupt care continuity for patients and create challenges insurers in managing the of their populations. Yet extent to which enrollees reenroll not widely known.To characterize rates disenrollment (hereafter, external turnover) reenrollment plans.In this retrospective longitudinal cohort study, trends turnover plans between January 1, 2006, August 31, 2018, were analyzed. Data...
In 2014, the biggest factor in expansion of U.S. health care coverage under Affordable Care Act was Medicaid, which produced 63% gains — but this effect comprised several distinct phenomena.
Structural integration is increasing among medical groups, but whether these changes yield care that more integrated remains unclear. We explored the relationships between structural characteristics of 144 groups and perceptions their patients. Patients' were measured by a validated national survey 3,067 Medicare beneficiaries with multiple chronic conditions across six domains reflect knowledge support of, communication with, patient. Medical groups' taken from National Study Physician...
In Duchenne muscular dystrophy (DMD), age at symptom onset and rate of decline thereafter vary considerably. This study contrasted disease progression over time using the North Star Ambulatory Assessment (NSAA) in an overall sample patients with DMD (mean 7.1 years; baseline total NSAA score 22.2) that a centrally representative subgroup 6.9 24.0) defined according to median loss ambulation. The average trajectory understated more rapid rates experienced by subgroup.
The Affordable Care Act (ACA) expands health insurance for Native Americans through Medicaid and Marketplace coverage, despite being exempt from the law's individual mandate.The ACA also permanently reauthorized Indian Health Improvement Act, which funds Service (IHS).The IHS provides care services to 2.2 million annually but is not considered by US government. 1 We evaluated changes in coverage among following ACA's implementation.Methods | used 2012-2014 American Community Survey (ACS),...
Evidence on the long-term efficacy of steroids in Duchenne muscular dystrophy (DMD) after loss ambulation is limited.Characterize and compare disease progression by steroid treatment (prednisone, deflazacort, or no steroids) among non-ambulatory boys with DMD.Disease was measured functional status (Performance Upper Limb Module for DMD 1.2 [PUL] Egen Klassifikation Scale Version 2 [EK] scale) cardiac pulmonary function (left ventricular ejection fraction [LVEF], forced vital capacity [FVC] %...
Aim: To examine benefits of corticosteroids for Duchenne muscular dystrophy (DMD) by age and disease progression. Methods: Data from daily steroid users (placebo-treated) were pooled four phase 2b/3 trials in DMD. Outcomes assessed overall among subgroups included changes baseline to 48 weeks six-minute walk distance (6MWD), timed function tests North Star Ambulatory Assessment total score. Results: Among 231 patients receiving deflazacort (n = 127) or prednisone 104), observed differences...
Administrative healthcare claims data provide a mechanism for assessing and monitoring multiple sclerosis (MS) disease status across large, clinically representative "real-world" populations. The estimation of MS using administrative can be challenge, however, due to lack detailed clinical information. Retrospective analyses in have traditionally used rates relapses approximate status. Healthcare costs may alternate, broader claims-based indicators activity because reflect facets care...
We reported recently that early use of inhaled nitric oxide therapy (iNO) for term and late preterm infants with hypoxic respiratory failure (HRF) at an oxygenation index (OI) ≥15 <20 is associated earlier discharge from the hospital, relative to babies treated OI ≥25. The objective present analysis determine whether iNO in this cohort leads lower cost medical care.We used a decision-analytic model, which was developed compare hospital resource costs versus standard HRF. model population...
Background: With the advent of new treatment options for venous thromboembolism (VTE), it is valuable to gain insights into current clinical practices. Objective: Assess patterns and recurrence among patients hospitalized VTE. Methods: This retrospective study evaluated with an incident VTE diagnosis (index) from 2008 2012 in a de-identified electronic health record database. Patients were further required receive anticoagulant and/or VTE-related procedure inclusion. excluded if they: (1)...
Health insurance design can influence the extent to which clinical care is well-coordinated. Through alternative payment models, Medicare Advantage (MA) and Accountable Care Organizations (ACOs) have potential improve integration relative traditional fee-for-service (FFS) Medicare.To characterize patient experiences of integrated within identify whether MA or ACO beneficiaries perceive greater than FFS beneficiaries.Retrospective cross-sectional analysis 2015 Current Beneficiary...
This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and explore how methodological differences may influence measured disparities.
Requirements for integrating care across providers, settings, and over time increase with patients' needs. Health providers' ability to offer that patients experience as integrated may vary among different levels of need. We explore the variation in perceptions Medicare beneficiaries based on beneficiary's level need using ordinary least square regression each four high-need groups: (a) complex chronic conditions, (b) frailties, (c) below 65 disability, (d) any (of first three) high control...
OBJECTIVE: To evaluate adherence among multiple sclerosis (MS) patients newly initiating a self-injectable versus oral disease-modifying drug (DMD). BACKGROUND: As the MS DMD class expands with entrants, it is important to understand how therapy may affect adherence. DESIGN/METHODS: (age 18-63; 蠅1 medical claim diagnosis: ICD-9-CM:340.xx) (first claim=index date), continuous eligibility 12 months pre- and post-index, no use during pre-index period, were identified from random sample of 5...
The growth of health care spending has been a longstanding policy concern.Over the years, several innovations have proposed to lower levels spending; however, their impact limited and not sustained over time.Costly new technology, while often an improvement existing care, identified as principal driver growth.Recent literature shown that high deductible plans (HDHP) can immediate on spending, but medium-and long-run effects remain unknown.In this paper, we use multiple-employer-group claims...
High health care spending growth is regarded in all countries as a potential policy problem. The for patient cost-sharing to reduce levels has been studied extensively; however, there very little work on how may also influence growth. In this paper, we relate deductibles measure of at the market level. We analyze novel combination US state-level panel datasets from 2002 2012 and find that higher deductible private group insurance are associated with significantly lower growth, particularly...
Background: Integrated care that is continuous, coordinated and patient-centered vital for Medicare beneficiaries, but its relationship to health expenditures remains unclear. Research Objective: This study explores—for the first time—the between integrated care, as measured from patient’s perspective, expenditures. Methods: Subjects include a sample of continuously eligible fee-for-service beneficiaries (n=8807) in 2015. Analyses draw on 7 previously validated measures patient-perceived...
OBJECTIVE: To evaluate predictors of bone fractures among patients with epilepsy. BACKGROUND: Adverse effects antiepileptic drugs (AED) include increased risk fracture, estimated to be 4-6% higher than the general population each year use. DESIGN/METHODS: Study were identified from 2006-2012 PharMetrics Plus Database. Continuously eligible (one pre-index [baseline] and one post-index [follow-up]) 蠅2 claims for epilepsy (ICD-9-CM 345.XX) selected. The first claim defined index date. An age-...